Chapter XI: Part 11

To the student I would say, that however plain and simple may be our teaching, he must expect to forget much which he follows intelligently in the lecture-room. But it is not the same as if he had never learned it. A man must get a thing before he can forget it. There is a great world of ideas we cannot voluntarily recall,--they are outside the limits of the will. But they sway our conscious thought as the unseen planets influence the movements of those within the sphere of vision. No man knows how much he knows,--how many ideas he has,--any more than he knows how many blood-globules roll in his veins. Sometimes accident brings back here and there one, but the mind is full of irrevocable remembrances and unthinkable thoughts, which take a part in all its judgments as indestructible forces. Some of you must feel your scientific deficiencies painfully after your best efforts. But every one can acquire what is most essential. A man of very moderate ability may be a good physician, if he devotes himself faithfully to the work. More than this, a positively dull man, in the ordinary acceptation of the term, sometimes makes a safer practitioner than one who has, we will say, five per cent. more brains than his average neighbor, but who thinks it is fifty per cent. more. Skulls belonging to this last variety of the human race are more common, I may remark, than specimens like the Neanderthal cranium, a cast of which you will find on the table in the Museum.

Whether the average talent be high or low, the Colleges of the land must make the best commodity they can out of such material as the country and the cities furnish them. The community must have Doctors as it must have bread. It uses up its Doctors just as it wears out its shoes, and requires new ones. All the bread need not be French rolls, all the shoes need not be patent leather ones; but the bread must be something that can be eaten, and the shoes must be something that can be worn. Life must somehow find food for the two forces that rub everything to pieces, or burn it to ashes,--friction and oxygen. Doctors are oxydable products, and the schools must keep furnishing new ones as the old ones turn into oxyds; some of first-rate quality that burn with a great light, some of a lower grade of brilliancy, some honestly, unmistakably, by the grace of God, of moderate gifts, or in simpler phrase, dull.

The public will give every honest and reasonably competent worker in the healing art a hearty welcome. It is on the whole very loyal to the Medical Profession. Three successive years have borne witness to the feeling with which this Institution, representing it in its educational aspect, is regarded by those who are themselves most honored and esteemed. The great Master of Natural Science bade the last year's class farewell in our behalf, in those accents which delight every audience. The Head of our ancient University honored us in the same way in the preceding season. And how can we forget that other occasion when the Chief Magistrate of the Commonwealth, that noble citizen whom we have just lost, large-souled, sweet-natured, always ready for every kind office, came among us at our bidding, and talked to us of our duties in words as full of wisdom as his heart was of goodness?

You have not much to fear, I think, from the fancy practitioners. The vulgar quackeries drop off, atrophied, one after another. Homoeopathy has long been encysted, and is carried on the body medical as quietly as an old wen. Every year gives you a more reasoning and reasonable people to deal with. See how it is in Literature. The dynasty of British dogmatists, after lasting a hundred years and more, is on its last legs. Thomas Carlyle, third in the line of descent, finds an audience very different from those which listened to the silver speech of Samuel Taylor Coleridge and the sonorous phrases of Samuel Johnson. We read him, we smile at his clotted English, his “swarmery” and other picturesque expressions, but we lay down his tirade as we do one of Dr. Cumming's interpretations of prophecy, which tells us that the world is coming to an end next week or next month, if the weather permits,--not otherwise,--feeling very sure that the weather will be unfavorable.

It is the same common-sense public you will appeal to. The less pretension you make, the better they will like you in the long run. I hope we shall make everything as plain and as simple to you as we can. I would never use a long word, even, where a short one would answer the purpose. I know there are professors in this country who “ligate” arteries. Other surgeons only tie them, and it stops the bleeding just as well. It is the familiarity and simplicity of bedside instruction which makes it so pleasant as well as so profitable. A good clinical teacher is himself a Medical School. We need not wonder that our young men are beginning to announce themselves not only as graduates of this or that College, but also as pupils of some one distinguished master.

I wish to close this Lecture, if you will allow me a few moments longer, with a brief sketch of an instructor and practitioner whose character was as nearly a model one in both capacities as I can find anywhere recorded.

Dr. JAMES JACKSON, Professor of the Theory and Practice of Medicine in this University from 1812 to 1846, and whose name has been since retained on our rolls as Professor Emeritus, died on the 27th of August last, in the ninetieth year of his age. He studied his profession, as I have already mentioned, with Dr. Holyoke of Salem, one of the few physicians who have borne witness to their knowledge of the laws of life by living to complete their hundredth year. I think the student took his Old Master, as he always loved to call him, as his model; each was worthy of the other, and both were bright examples to all who come after them.

I remember that in the sermon preached by Dr. Grazer after Dr. Holyoke's death, one of the points most insisted upon as characteristic of that wise and good old man was the perfect balance of all his faculties. The same harmonious adjustment of powers, the same symmetrical arrangement of life, the same complete fulfilment of every day's duties, without haste and without needless delay, which characterized the master, equally distinguished the scholar. A glance at the life of our own Old Master, if I can do any justice at all to his excellences, will give you something to carry away from this hour's meeting not unworthy to be remembered.

From December, 1797, to October, 1799, he remained with Dr. Holyoke as a student, a period which he has spoken of as a most interesting and most gratifying part of his life. After this he passed eight months in London, and on his return, in October, 1800, he began business in Boston.

He had followed Mr. Cline, as I have mentioned, and was competent to practise Surgery. But he found Dr. John Collins Warren had already occupied the ground which at that day hardly called for more than one leading practitioner, and wisely chose the Medical branch of the profession. He had only himself to rely upon, but he had confidence in his prospects, conscious, doubtless, of his own powers, knowing his own industry and determination, and being of an eminently cheerful and hopeful disposition. No better proof of his spirit can be given than that, just a year from the time when he began to practise as a physician, he took that eventful step which in such a man implies that he sees his way clear to a position; he married a lady blessed with many gifts, but not bringing him a fortune to paralyze his industry.

He had not miscalculated his chances in life. He very soon rose into a good practice, and began the founding of that reputation which grew with his years, until he stood by general consent at the head of his chosen branch of the profession, to say the least, in this city and in all this region of country. His skill and wisdom were the last tribunal to which the sick and suffering could appeal. The community trusted and loved him, the profession recognized him as the noblest type of the physician. The young men whom he had taught wandered through foreign hospitals; where they learned many things that were valuable, and many that were curious; but as they grew older and began to think more of their ability to help the sick than their power of talking about phenomena, they began to look back to the teaching of Dr. Jackson, as he, after his London experience, looked back to that of Dr. Holyoke. And so it came to be at last that the bare mention of his name in any of our medical assemblies would call forth such a tribute of affectionate regard as is only yielded to age when it brings with it the record of a life spent in well doing.

No accident ever carries a man to eminence such as his in the medical profession. He who looks for it must want it earnestly and work for it vigorously; Nature must have qualified him in many ways, and education must have equipped him with various knowledge, or his reputation will evaporate before it reaches the noon-day blaze of fame. How did Dr. Jackson gain the position which all conceded to him? In the answer to this question some among you may find a key that shall unlock the gate opening on that fair field of the future of which all dream but which not all will ever reach.

First of all, he truly loved his profession. He had no intellectual ambitions outside of it, literary, scientific or political. To him it was occupation enough to apply at the bedside the best of all that he knew for the good of his patient; to protect the community against the inroads of pestilence; to teach the young all that he himself had been taught, with all that his own experience had added; to leave on record some of the most important results of his long observation.

With his patients he was so perfect at all points that it is hard to overpraise him. I have seen many noted British and French and American practitioners, but I never saw the man so altogether admirable at the bedside of the sick as Dr. James Jackson. His smile was itself a remedy better than the potable gold and the dissolved pearls that comforted the praecordia of mediaeval monarchs. Did a patient, alarmed without cause, need encouragement, it carried the sunshine of hope into his heart and put all his whims to flight, as David's harp cleared the haunted chamber of the sullen king. Had the hour come, not for encouragement, but for sympathy, his face, his voice, his manner all showed it, because his heart felt it. So gentle was he, so thoughtful, so calm, so absorbed in the case before him, not to turn round and look for a tribute to his sagacity, not to bolster himself in a favorite theory, but to find out all he could, and to weigh gravely and cautiously all that he found, that to follow him in his morning visit was not only to take a lesson in the healing art, it was learning how to learn, how to move, how to look, how to feel, if that can be learned. To visit with Dr. Jackson was a medical education.

He was very firm, with all his kindness. He would have the truth about his patients. The nurses found it out; and the shrewder ones never ventured to tell him anything but a straight story. A clinical dialogue between Dr. Jackson and Miss Rebecca Taylor, sometime nurse in the Massachusetts General Hospital, a mistress in her calling, was as good questioning and answering as one would be like to hear outside of the court-room.

Of his practice you can form an opinion from his book called “Letters to a Young Physician.” Like all sensible men from the days of Hippocrates to the present, he knew that diet and regimen were more important than any drug or than all drugs put together. Witness his treatment of phthisis and of epilepsy. He retained, however, more confidence in some remedial agents than most of the younger generation would concede to them. Yet his materia medica was a simple one.

“When I first went to live with Dr. Holyoke,” he says, “in 1797, showing me his shop, he said, 'There seems to you to be a great variety of medicines here, and that it will take you long to get acquainted with them, but most of them are unimportant. There are four which are equal to all the rest, namely, Mercury, Antimony, Bark and Opium.'” And Dr. Jackson adds, “I can only say of his practice, the longer I have lived, I have thought better and better of it.” When he thought it necessary to give medicine, he gave it in earnest. He hated half-practice--giving a little of this or that, so as to be able to say that one had done something, in case a consultation was held, or a still more ominous event occurred. He would give opium, for instance, as boldly as the late Dr. Fisher of Beverly, but he followed the aphorism of the Father of Medicine, and kept extreme remedies for extreme cases.

When it came to the “non-naturals,” as he would sometimes call them, after the old physicians,--namely, air, meat and drink, sleep and watching, motion and rest, the retentions and excretions, and the affections of the mind,--he was, as I have said, of the school of sensible practitioners, in distinction from that vast community of quacks, with or without the diploma, who think the chief end of man is to support apothecaries, and are never easy until they can get every patient upon a regular course of something nasty or noxious. Nobody was so precise in his directions about diet, air, and exercise, as Dr. Jackson. He had the same dislike to the a peu pres, the about so much, about so often, about so long, which I afterwards found among the punctilious adherents of the numerical system at La Pitie.

He used to insist on one small point with a certain philological precision, namely, the true meaning of the word “cure.” He would have it that to cure a patient was simply to care for him. I refer to it as showing what his idea was of the relation of the physician to the patient. It was indeed to care for him, as if his life were bound up in him, to watch his incomings and outgoings, to stand guard at every avenue that disease might enter, to leave nothing to chance; not merely to throw a few pills and powders into one pan of the scales of Fate, while Death the skeleton was seated in the other, but to lean with his whole weight on the side of life, and shift the balance in its favor if it lay in human power to do it. Such devotion as this is only to be looked for in the man who gives himself wholly up to the business of healing, who considers Medicine itself a Science, or if not a science, is willing to follow it as an art,--the noblest of arts, which the gods and demigods of ancient religions did not disdain to practise and to teach.

The same zeal made him always ready to listen to any new suggestion which promised to be useful, at a period of life when many men find it hard to learn new methods and accept new doctrines. Few of his generation became so accomplished as he in the arts of direct exploration; coming straight from the Parisian experts, I have examined many patients with him, and have had frequent opportunities of observing his skill in percussion and auscultation.

One element in his success, a trivial one compared with others, but not to be despised, was his punctuality. He always carried two watches,--I doubt if he told why, any more than Dr. Johnson told what he did with the orange-peel,--but probably with reference to this virtue. He was as much to be depended upon at the appointed time as the solstice or the equinox. There was another point I have heard him speak of as an important rule with him; to come at the hour when he was expected; if he had made his visit for several days successively at ten o'clock, for instance, not to put it off, if he could possibly help it, until eleven, and so keep a nervous patient and an anxious family waiting for him through a long, weary hour.

If I should attempt to characterize his teaching, I should say that while it conveyed the best results of his sagacious and extended observation, it was singularly modest, cautious, simple, sincere. Nothing was for show, for self-love; there was no rhetoric, no declamation, no triumphant “I told you so,” but the plain statement of a clear-headed honest man, who knows that he is handling one of the gravest subjects that interest humanity. His positive instructions were full of value, but the spirit in which he taught inspired that loyal love of truth which lies at the bottom of all real excellence.

I will not say that, during his long career, Dr. Jackson never made an enemy. I have heard him tell how, in his very early days, old Dr. Danforth got into a towering passion with him about some professional consultation, and exploded a monosyllable or two of the more energetic kind on the occasion. I remember that that somewhat peculiar personage, Dr. Waterhouse, took it hardly when Dr. Jackson succeeded to his place as Professor of Theory and Practice. A young man of Dr. Jackson's talent and energy could hardly take the position that belonged to him without crowding somebody in a profession where three in a bed is the common rule of the household. But he was a peaceful man and a peace-maker all his days. No man ever did more, if so much, to produce and maintain the spirit of harmony for which we consider our medical community as somewhat exceptionally distinguished.

If this harmony should ever be threatened, I could wish that every impatient and irritable member of the profession would read that beautiful, that noble Preface to the “Letters,” addressed to John Collins Warren. I know nothing finer in the medical literature of all time than this Prefatory Introduction. It is a golden prelude, fit to go with the three great Prefaces which challenge the admiration of scholars,--Calvin's to his Institutes, De Thou's to his History, and Casaubon's to his Polybius,--not because of any learning or rhetoric, though it is charmingly written, but for a spirit flowing through it to which learning and rhetoric are but as the breath that is wasted on the air to the Mood that warms the heart.

Of a similar character is this short extract which I am permitted to make from a private letter of his to a dear young friend. He was eighty-three years old at the time of writing it.

“I have not loved everybody whom I have known, but I have striven to see the good points in the characters of all men and women. At first I must have done this from something in my own nature, for I was not aware of it, and yet was doing it without any plan, when one day, sixty years ago, a friend whom I loved and respected said this to me, 'Ah, James, I see that you are destined to succeed in the world, and to make friends, because you are so ready to see the good point in the characters of those you meet.'”

I close this imperfect notice of some features in the character of this most honored and beloved of physicians by applying to him the words which were written of William Heberden, whose career was not unlike his own, and who lived to the same patriarchal age.

“From his early youth he had always entertained a deep sense of religion, a consummate love of virtue, an ardent thirst after knowledge, and an earnest desire to promote the welfare and happiness of all mankind. By these qualities, accompanied with great sweetness of manners, he acquired the love and esteem of all good men, in a degree which perhaps very few have experienced; and after passing an active life with the uniform testimony of a good conscience, he became an eminent example of its influence, in the cheerfulness and serenity of his latest age.”

Such was the man whom I offer to you as a model, young gentlemen, at the outset of your medical career. I hope that many of you will recognize some traits of your own special teachers scattered through various parts of the land in the picture I have drawn. Let me assure you that whatever you may learn in this or any other course of public lectures,--and I trust you will learn a great deal,--the daily guidance, counsel, example, of your medical father, for such the Oath of Hippocrates tells you to consider your preceptor, will, if he is in any degree like him of whom I have spoken, be the foundation on which all that we teach is reared, and perhaps outlive most of our teachings, as in Dr. Jackson's memory the last lessons that remained with him were those of his Old Master.

THE MEDICAL PROFESSION IN MASSACHUSETTS.

A Lecture of a Course by members of the Massachusetts Historical Society, delivered before the Lowell Institute, January 29, 1869.

The medical history of eight generations, told in an hour, must be in many parts a mere outline. The details I shall give will relate chiefly to the first century. I shall only indicate the leading occurrences, with the more prominent names of the two centuries which follow, and add some considerations suggested by the facts which have been passed in review.

A geographer who was asked to describe the tides of Massachusetts Bay, would have to recognize the circumstance that they are a limited manifestation of a great oceanic movement. To consider them apart from this, would be to localize a planetary phenomenon, and to provincialize a law of the universe. The art of healing in Massachusetts has shared more or less fully and readily the movement which, with its periods of ebb and flow, has been raising its level from age to age throughout the better part of Christendom. Its practitioners brought with them much of the knowledge and many of the errors of the Old World; they have always been in communication with its wisdom and its folly; it is not without interest to see how far the new conditions in which they found themselves have been favorable or unfavorable to the growth of sound medical knowledge and practice.

The state of medicine is an index of the civilization of an age and country,--one of the best, perhaps, by which it can be judged. Surgery invokes the aid of all the mechanical arts. From the rude violences of the age of stone,--a relic of which we may find in the practice of Zipporah, the wife of Moses,--to the delicate operations of to-day upon patients lulled into temporary insensibility, is a progress which presupposes a skill in metallurgy and in the labors of the workshop and the laboratory it has taken uncounted generations to accumulate. Before the morphia which deadens the pain of neuralgia, or the quinine which arrests the fit of an ague, can find their place in our pharmacies, commerce must have perfected its machinery, and science must have refined its processes, through periods only to be counted by the life of nations. Before the means which nature and art have put in the hands of the medical practitioner can be fairly brought into use, the prejudices of the vulgar must be overcome, the intrusions of false philosophy must be fenced out, and the partnership with the priesthood dissolved. All this implies that freedom and activity of thought which belong only to the most advanced conditions of society; and the progress towards this is by gradations as significant of wide-spread changes, as are the varying states of the barometer of far-extended conditions of the atmosphere.

Apart, then, from its special and technical interest, my subject has a meaning which gives a certain importance, and even dignity, to details in themselves trivial and almost unworthy of record. A medical entry in Governor Winthrop's journal may seem at first sight a mere curiosity; but, rightly interpreted, it is a key to his whole system of belief as to the order of the universe and the relations between man and his Maker. Nothing sheds such light on the superstitions of an age as the prevailing interpretation and treatment of disease. When the touch of a profligate monarch was a cure for one of the most inveterate of maladies, when the common symptoms of hysteria were prayed over as marks of demoniacal possession, we might well expect the spiritual realms of thought to be peopled with still stranger delusions.

Let us go before the Pilgrims of the Mayflower, and look at the shores on which they were soon to land. A wasting pestilence had so thinned the savage tribes that it was sometimes piously interpreted as having providentially prepared the way for the feeble band of exiles. Cotton Mather, who, next to the witches, hated the “tawnies,” “wild beasts,” “blood-hounds,” “rattlesnakes,” “infidels,” as in different places he calls the unhappy Aborigines, describes the condition of things in his lively way, thus: “The Indians in these Parts had newly, even about a Year or Two before, been visited with such a prodigious Pestilence; as carried away not a Tenth, but Nine Parts of Ten (yea't is said Nineteen of Twenty) among them so that the Woods were almost cleared of those pernicious Creatures to make Room for a better Growth.”

What this pestilence was has been much discussed. It is variously mentioned by different early writers as “the plague,” “a great and grievous plague,” “a sore consumption,” as attended with spots which left unhealed places on those who recovered, as making the “whole surface yellow as with a garment.” Perhaps no disease answers all these conditions so well as smallpox. We know from different sources what frightful havoc it made among the Indians in after years,--in 1631, for instance, when it swept away the aboriginal inhabitants of “whole towns,” and in 1633. We have seen a whole tribe, the Mandans, extirpated by it in our own day. The word “plague” was used very vaguely, as in the description of the “great sickness” found among the Indians by the expedition of 1622. This same great sickness could hardly have been yellow fever, as it occurred in the month of November. I cannot think, therefore, that either the scourge of the East or our Southern malarial pestilence was the disease that wasted the Indians. As for the yellowness like a garment, that is too familiar to the eyes of all who have ever looked on the hideous mask of confluent variola.

Without the presence or the fear of these exotic maladies, the forlorn voyagers of the Mayflower had sickness enough to contend with. At their first landing at Cape Cod, gaunt and hungry and longing for fresh food, they found upon the sandy shore “great mussels, and very fat and full of sea-pearl.” Sailors and passengers indulged in the treacherous delicacy; which seems to have been the sea-clam; and found that these mollusks, like the shell the poet tells of, remembered their august abode, and treated the way-worn adventurers to a gastric reminiscence of the heaving billows. In the mean time it blew and snowed and froze. The water turned to ice on their clothes, and made them many times like coats of iron. Edward Tilley had like to have “sounded” with cold. The gunner, too, was sick unto death, but “hope of trucking” kept him on his feet,--a Yankee, it should seem, when he first touched the shore of New England. Most, if not all, got colds and coughs, which afterwards turned to scurvy, whereof many died.

How can we wonder that the crowded and tempest-tossed voyagers, many of them already suffering, should have fallen before the trials of the first winter in Plymouth? Their imperfect shelter, their insufficient supply of bread, their salted food, now in unwholesome condition, account too well for the diseases and the mortality that marked this first dreadful season; weakness, swelling of the limbs, and other signs of scurvy, betrayed the want of proper nourishment and protection from the elements. In December six of their number died, in January eight, in February, seventeen, in March thirteen. With the advance of spring the mortality diminished, the sick and lame began to recover, and the colonists, saddened but not disheartened, applied themselves to the labors of the opening year.

One of the most pressing needs of the early colonists must have been that of physicians and surgeons. In Mr. Savage's remarkable Genealogical Dictionary of the first settlers who came over before 1692 and their descendants to the third generation, I find scattered through the four crowded volumes the names of one hundred and thirty-four medical practitioners. Of these, twelve, and probably many more, practised surgery; three were barber-surgeons. A little incident throws a glimmer from the dark lantern of memory upon William Direly, one of these practitioners with the razor and the lancet. He was lost between Boston and Roxbury in a violent tempest of wind and snow; ten days afterwards a son was born to his widow, and with a touch of homely sentiment, I had almost said poetry, they called the little creature “Fathergone” Direly. Six or seven, probably a larger number, were ministers as well as physicians, one of whom, I am sorry to say, took to drink and tumbled into the Connecticut River, and so ended. One was not only doctor, but also schoolmaster and poet. One practised medicine and kept a tavern. One was a butcher, but calls himself a surgeon in his will, a union of callings which suggests an obvious pleasantry. One female practitioner, employed by her own sex,--Ann Moore,--was the precursor of that intrepid sisterhood whose cause it has long been my pleasure and privilege to advocate on all fitting occasions.

Outside of this list I must place the name of Thomas Wilkinson, who was complained of, in 1676, for practising contrary to law.

Many names in the catalogue of these early physicians have been associated, in later periods, with the practice of the profession, --among them, Boylston, Clark, Danforth, Homan, Jeffrey, Kittredge, Oliver, Peaslee, Randall, Shattuck, Thacher, Wellington, Williams, Woodward. Touton was a Huguenot, Burchsted a German from Silesia, Lunerus a German or a Pole; “Pighogg Churrergeon,” I hope, for the honor of the profession, was only Peacock disguised under this alias, which would not, I fear, prove very attractive to patients.

What doctrines and practice were these colonists likely to bring, with them?

Two principal schools of medical practice prevailed in the Old World during the greater part of the seventeenth century. The first held to the old methods of Galen: its theory was that the body, the microcosm, like the macrocosm, was made up of the four elements--fire, air, water, earth; having respectively the qualities hot, dry, moist, cold. The body was to be preserved in health by keeping each of these qualities in its natural proportion; heat, by the proper temperature; moisture, by the due amount of fluid; and so as to the rest. Diseases which arose from excess of heat were to be attacked by cooling remedies; those from excess of cold, by heating ones; and so of the other derangements of balance. This was truly the principle of contraries contrariis, which ill-informed persons have attempted to make out to be the general doctrine of medicine, whereas there is no general dogma other than this: disease is to be treated by anything that is proved to cure it. The means the Galenist employed were chiefly diet and vegetable remedies, with the use of the lancet and other depleting agents. He attributed the four fundamental qualities to different vegetables, in four different degrees; thus chicory was cold in the fourth degree, pepper was hot in the fourth, endive was cold and dry in the second, and bitter almonds were hot in the first and dry in the second degree. When we say “cool as a cucumber,” we are talking Galenism. The seeds of that vegetable ranked as one of “the four greater cold seeds” of this system.

Galenism prevailed mostly in the south of Europe and France. The readers of Moliere will have no difficulty in recalling some of its favorite modes of treatment, and the abundant mirth he extracted from them.

These Galenists were what we should call “herb-doctors” to-day. Their insignificant infusions lost credit after a time; their absurdly complicated mixtures excited contempt, and their nauseous prescriptions provoked loathing and disgust. A simpler and bolder practice found welcome in Germany, depending chiefly on mineral remedies, mercury, antimony, sulphur, arsenic, and the use, sometimes the secret use, of opium. Whatever we think of Paracelsus, the chief agent in the introduction of these remedies, and whatever limits we may assign to the use of these long-trusted mineral drugs, there can be no doubt that the chemical school, as it was called, did a great deal towards the expurgation of the old, overloaded, and repulsive pharmacopoeia. We shall find evidence in the practice of our New-England physicians of the first century, that they often employed chemical remedies, and that, by the early part of the following century, their chief trust was in the few simple, potent drugs of Paracelsus.

We have seen that many of the practitioners of medicine, during the first century of New England, were clergymen. This relation between medicine and theology has existed from a very early period; from the Egyptian priest to the Indian medicine-man, the alliance has been maintained in one form or another. The partnership was very common among our British ancestors. Mr. Ward, the Vicar of Stratford-on-Avon, himself a notable example of the union of the two characters, writing about 1660, says,

“The Saxons had their blood-letters, but under the Normans physicke, begunne in England; 300 years agoe itt was not a distinct profession by itself, but practised by men in orders, witness Nicholas de Ternham, the chief English physician and Bishop of Durham; Hugh of Evesham, a physician and cardinal; Grysant, physician and pope; John Chambers, Dr. of Physick, was the first Bishop of Peterborough; Paul Bush, a bachelor of divinitie in Oxford, was a man well read in physick as well as divinitie, he was the first bishop of Bristol.”

“Again in King Richard the Second's time physicians and divines were not distinct professions; for one Tydeman, Bishop of Landaph and Worcester, was physician to King Richard the Second.”

This alliance may have had its share in creating and keeping up the many superstitions which have figured so largely in the history of medicine. It is curious to see that a medical work left in manuscript by the Rev. Cotton Mather and hereafter to be referred to, is running over with follies and superstitious fancies; while his contemporary and fellow-townsman, William Douglass, relied on the same few simple remedies which, through Dr. Edward Holyoke and Dr. James Jackson, have come down to our own time, as the most important articles of the materia medica.

Let us now take a general glance at some of the conditions of the early settlers; and first, as to the healthfulness of the climate. The mortality of the season that followed the landing of the Pilgrims at Plymouth has been sufficiently accounted for. After this, the colonists seem to have found the new country agreeing very well with their English constitutions. Its clear air is the subject of eulogy. Its dainty springs of sweet water are praised not only by Higginson and Wood, but even the mischievous Morton says, that for its delicate waters “Canaan came not near this country.” There is a tendency to dilate on these simple blessings, which reminds one a little of the Marchioness in Dickens's story, with her orange-peel-and-water beverage. Still more does one feel the warmth of coloring,--such as we expect from converts to a new faith, and settlers who want to entice others over to their clearings, when Winslow speaks, in 1621, of “abundance of roses, white, red, and damask; single, but very sweet indeed;” a most of all, however, when, in the same connection, he says, “Here are grapes white and red, and very sweet and strong also.” This of our wild grape, a little vegetable Indian, which scalps a civilized man's mouth, as his animal representative scalps his cranium. But there is something quite charming in Winslow's picture of the luxury in which they are living. Lobsters, oysters, eels, mussels, fish and fowl, delicious fruit, including the grapes aforesaid,--if they only had “kine, horses, and sheep,” he makes no question but men would live as contented here as in any part of the world. We cannot help admiring the way in which they took their trials, and made the most of their blessings.

“And how Content they were,” says Cotton Mather, “when an Honest Man, as I have heard, inviting his Friends to a Dish of Clams, at the Table gave Thanks to Heaven, who had given them to suck the abundance of the Seas, and of the Treasures Hid in the Sands!”

Strangely enough, as it would seem, except for this buoyant determination to make the best of everything, they hardly appear to recognize the difference of the climate from that which they had left. After almost three years' experience, Winslow says, he can scarce distinguish New England from Old England, in respect of heat and cold, frost, snow, rain, winds, etc. The winter, he thinks (if there is a difference), is sharper and longer; but yet he may be deceived by the want of the comforts he enjoyed at home. He cannot conceive any climate to agree better with the constitution of the English, not being oppressed with extremity of heats, nor nipped by biting cold:

“By which means, blessed be God, we enjoy our health, notwithstanding those difficulties we have undergone, in such a measure as would have been admired, if we had lived in England with the like means.”

Edward Johnson, after mentioning the shifts to which they were put for food, says,--

“And yet, methinks, our children are as cheerful, fat, and lusty, with feeding upon those mussels, clams, and other fish, as they were in England with their fill of bread.”

Higginson, himself a dyspeptic, “continually in physic,” as he says, and accustomed to dress in thick clothing, and to comfort his stomach with drink that was “both strong and stale,”--the “jolly good ale and old,” I suppose, of free and easy Bishop Still's song,--found that he both could and did oftentimes drink New England water very well,--which he seems to look upon as a remarkable feat. He could go as lightclad as any, too, with only a light stuff cassock upon his shirt, and stuff breeches without linings. Two of his children were sickly: one,--little misshapen Mary,--died on the passage, and, in her father's words, “was the first in our ship that was buried in the bowels of the great Atlantic sea;” the other, who had been “most lamentably handled” by disease, recovered almost entirely “by the very wholesomeness of the air, altering, digesting, and drying up the cold and crude humors of the body.” Wherefore, he thinks it a wise course for all cold complexions to come to take physic in New England, and ends with those often quoted words, that “a sup of New England's air is better than a whole draught of Old England's ale.” Mr. Higginson died, however, “of a hectic fever,” a little more than a year after his arrival.

The medical records which I shall cite show that the colonists were not exempt from the complaints of the Old World. Besides the common diseases to which their descendants are subject, there were two others, to say nothing of the dreaded small-pox, which later medical science has disarmed,--little known among us at the present day, but frequent among the first settlers. The first of these was the scurvy, already mentioned, of which Winthrop speaks in 1630, saying, that it proved fatal to those who fell into discontent, and lingered after their former conditions in England; the poor homesick creatures in fact, whom we so forget in our florid pictures of the early times of the little band in the wilderness. Many who were suffering from scurvy got well when the Lyon arrived from England, bringing store of juice of lemons. The Governor speaks of another case in 1644; and it seems probable that the disease was not of rare occurrence.

The other complaint from which they suffered, but which has nearly disappeared from among us, was intermittent fever, or fever and ague. I investigated the question as to the prevalence of this disease in New England, in a dissertation, which was published in a volume with other papers, in the year 1838. I can add little to the facts there recorded. One which escaped me was, that Joshua Scottow, in “Old Men's Tears,” dated 1691, speaks of “shaking agues,” as among the trials to which they had been subjected. The outline map of New England, accompanying the dissertation above referred to, indicates all the places where I had evidence that the disease had originated. It was plain enough that it used to be known in many localities where it has long ceased to be feared. Still it was and is remarkable to see what a clean bill of health in this particular respect our barren soil inherited with its sterility. There are some malarious spots on the edge of Lake Champlain, and there have been some temporary centres of malaria, within the memory of man, on one or more of our Massachusetts rivers, but these are harmless enough, for the most part, unless the millers dam them, when they are apt to retaliate with a whiff from their meadows, that sets the whole neighborhood shaking with fever and ague.

The Pilgrims of the Mayflower had with them a good physician, a man of standing, a deacon of their church, one whom they loved and trusted, Dr. Samuel Fuller. But no medical skill could keep cold and hunger and bad food, and, probably enough, desperate homesickness in some of the feebler sort, from doing their work. No detailed record remains of what they suffered or what was attempted for their relief during the first sad winter. The graves of those who died were levelled and sowed with grain that the losses of the little band might not be suspected by the savage tenants of the wilderness, and their story remains untold.

Of Dr. Fuller's practice, at a later period, we have an account in a letter of his to Governor Bradford, dated June, 1630. “I have been to Matapan” (now Dorchester), he says, “and let some twenty of those people blood.” Such wholesale depletion as this, except with avowed homicidal intent, is quite unknown in these days; though I once saw the noted French surgeon, Lisfranc, in a fine phlebotomizing frenzy, order some ten or fifteen patients, taken almost indiscriminately, to be bled in a single morning.

Dr. Fuller's two visits to Salem, at the request of Governor Endicott, seem to have been very satisfactory to that gentleman. Morton, the wild fellow of Merry Mount, gives a rather questionable reason for the Governor's being so well pleased with the physician's doings. The names under which he mentions the two personages, it will be seen, are not intended to be complimentary. “Dr. Noddy did a great cure for Captain Littleworth. He cured him of a disease called a wife.” William Gager, who came out with Winthrop, is spoken of as “a right godly man and skilful chyrurgeon, but died of a malignant fever not very long after his arrival.”

Two practitioners of the ancient town of Newbury are entitled to special notice, for different reasons. The first is Dr. John Clark, who is said by tradition to have been the first regularly educated physician who resided in New England. His portrait, in close-fitting skull-cap, with long locks and venerable flowing beard, is familiar to our eyes on the wall of our Society's antechamber. His left hand rests upon a skull, his right hand holds an instrument which deserves a passing comment. It is a trephine, a surgical implement for cutting round pieces out of broken skulls, so as to get at the fragments which have been driven in, and lift them up. It has a handle like that of a gimlet, with a claw like a hammer, to lift with, I suppose, which last contrivance I do not see figured in my books. But the point I refer to is this: the old instrument, the trepan, had a handle like a wimble, what we call a brace or bit-stock. The trephine is not mentioned at all in Peter Lowe's book, London, 1634; nor in Wiseman's great work on Surgery, London, 1676; nor in the translation of Dionis, published by Jacob Tonson, in 1710. In fact it was only brought into more general use by Cheselden and Sharpe so late as the beginning of the last century. As John Clark died in 1661, it is remarkable to see the last fashion in the way of skull-sawing contrivances in his hands,--to say nothing of the claw on the handle, and a Hey's saw, so called in England, lying on the table by him, and painted there more than a hundred years before Hey was born. This saw is an old invention, perhaps as old as Hippocrates, and may be seen figured in the “Armamentarium Chirurgicum” of Scultetus, or in the Works of Ambroise Pare.

Dr. Clark is said to have received a diploma before he came, for skill in lithotomy. He loved horses, as a good many doctors do, and left a good property, as they all ought to do. His grave and noble presence, with the few facts concerning him, told with more or less traditional authority, give us the feeling that the people of Newbury, and afterwards of Boston, had a wise and skilful medical adviser and surgeon in Dr. John Clark.

The venerable town of Newbury had another physician who was less fortunate. The following is a court record of 1652:

“This is to certify whom it may concern, that we the subscribers, being called upon to testify against doctor William Snelling for words by him uttered, affirm that being in way of merry discourse, a health being drank to all friends, he answered,

“I'll pledge my friends,
And for my foes
A plague for their heels
And,'----

[a similar malediction on the other extremity of their feet.]

“Since when he hath affirmed that he only intended the proverb used in the west country, nor do we believe he intended otherwise.

“[Signed] WILLIAM THOMAS.

“THOMAS MILWARD.”

“March 12th 1651, All which I acknowledge, and am sorry I did not expresse my intent, or that I was so weak as to use so foolish a proverb.

“[Signed] GULIELMUS SNELLING.”

Notwithstanding this confession and apology, the record tells us that “William Snelling in his presentment for cursing is fined ten shillings and the fees of court.”

I will mention one other name among those of the Fathers of the medical profession in New England. The “apostle” Eliot says, writing in 1647, “We never had but one anatomy in the country, which Mr. Giles Firman, now in England, did make and read upon very well.”

Giles Firmin, as the name is commonly spelled, practised physic in this country for a time. He seems to have found it a poor business; for, in a letter to Governor Winthrop, he says, “I am strongly sett upon to studye divinitie: my studyes else must be lost, for physick is but a meene helpe.”

Giles Firmin's Lectures on Anatomy were the first scientific teachings of the New World. While the Fathers were enlightened enough to permit such instructions, they were severe in dealing with quackery; for, in 1631, our court records show that one Nicholas Knopp, or Knapp, was sentenced to be fined or whipped “for taking upon him to cure the scurvey by a water of noe worth nor value, which he solde att a very deare rate.” Empty purses or sore backs would be common with us to-day if such a rule were enforced.

Besides the few worthies spoken of, and others whose names I have not space to record, we must remember that there were many clergymen who took charge of the bodies as well as the souls of their patients, among them two Presidents of Harvard College, Charles Chauncy and Leonard Hoar,--and Thomas Thacher, first minister of the “Old South,” author of the earliest medical treatises printed in the country, [A Brief Rule to Guide the Common People in Small pox and Measles. 1674.] whose epitaph in Latin and Greek, said to have been written by Eleazer, an “Indian Youth” and a member of the Senior Class of Harvard College, may be found in the “Magnalia.” I miss this noble savage's name in our triennial catalogue; and as there is many a slip between the cup and lip, one is tempted to guess that he may have lost his degree by some display of his native instinct,--possibly a flourish of the tomahawk or scalping-knife. However this may have been, the good man he celebrated was a notable instance of the Angelical Conjunction, as the author of the “Magnalia” calls it, of the offices of clergyman and medical practitioner.

Michael Wigglesworth, author of the “Day of Doom,” attended the sick, “not only as a Pastor, but as a Physician too, and this, not only in his own town, but also in all those of the vicinity.” Mather says of the sons of Charles Chauncy, “All of these did, while they had Opportunity, Preach the Gospel; and most, if not all of them, like their excellent Father before them, had an eminent skill in physick added unto their other accomplishments,” etc. Roger Williams is said to have saved many in a kind of pestilence which swept away many Indians.

To these names must be added, as sustaining a certain relation to the healing art, that of the first Governor Winthrop, who is said by John Cotton to have been “Help for our Bodies by Physick [and] for our Estates by Law,” and that of his son, the Governor of Connecticut, who, as we shall see, was as much physician as magistrate.

I had submitted to me for examination, in 1862, a manuscript found among the Winthrop Papers, marked with the superscription, “For my worthy friend Mr. Wintrop,” dated in 1643, London, signed Edward Stafford, and containing medical directions and prescriptions. It may be remembered by some present that I wrote a report on this paper, which was published in the “Proceedings” of this Society. Whether the paper was written for Governor John Winthrop of Massachusetts, or for his son, Governor John of Connecticut, there is no positive evidence that I have been able to obtain. It is very interesting, however, as giving short and simple practical directions, such as would be most like to be wanted and most useful, in the opinion of a physician in repute of that day.

The diseases prescribed for are plague, small-pox, fevers, king's evil, insanity, falling-sickness, and the like; with such injuries as broken bones, dislocations, and burning with gunpowder. The remedies are of three kinds: simples, such as St. John's wort, Clown's all-heal, elder, parsley, maidenhair, mineral drugs, such as lime, saltpetre, Armenian bole, crocus metallorum, or sulphuret of antimony; and thaumaturgic or mystical, of which the chief is, “My black powder against the plague, small-pox; purples, all sorts of feavers; Poyson; either, by Way of Prevention or after Infection.” This marvellous remedy was made by putting live toads into an earthen pot so as to half fill it, and baking and burning them “in the open ayre, not in an house,”--concerning which latter possibility I suspect Madam Winthrop would have had something to say,--until they could be reduced by pounding, first into a brown, and then into a black, powder. Blood-letting in some inflammations, fasting in the early stage of fevers, and some of those peremptory drugs with which most of us have been well acquainted in our time, the infragrant memories of which I will not pursue beyond this slight allusion, are among his remedies.